October 17, 2025
Learn how low, moderate, and high-intensity exercise affect cortisol—and how cortisol patterns influence anxiety, depression, sleep, and overall health.
Cortisol follows a diurnal pattern: high in the morning (with a distinct Cortisol Awakening Response, CAR) and gradually declines across the day. When the slope flattens (e.g., elevated evening levels or blunted morning rise), studies link this to poorer mental and physical health.
Why we care clinically: across the lifespan, chronic stress and glucocorticoid exposure remodel brain regions involved in mood, memory, and threat detection (e.g., hippocampus, amygdala, prefrontal cortex), helping explain associations with depression, anxiety, cognitive change, and stress-related conditions.
Typical cortisol response: minimal rise or no change; can facilitate recovery/sleep when timed well. Evidence synthesizing physical activity interventions suggests small decreases in cortisol and better sleep, supporting frequent use of this tier.
Threshold effects: around ~60% VO₂max is the point at which cortisol reliably starts to rise during exercise—still a physiological, adaptive response.
Pattern: Immediate post-exercise increases are expected, then drop below baseline in ~2–3 hours and return to baseline by ~24 hours in healthy adults. This is not harmful in isolation and can blunt later stress responses.
Resistance training: intense sessions acutely raise cortisol; again, this is transient and part of normal remodeling.
Clinical bottom line: An acute cortisol rise during hard work is normal, short-lived, and adaptive. Problems arise when overall life stress, undersleep, or illness push the entire day’s curve into a chronically elevated or flattened pattern, not from the post-workout bump itself.
Depression & anxiety: Reviews across animal and human studies link chronic glucocorticoid exposure and altered HPA signaling with depressive symptoms, anxiety phenotypes, and cognitive changes; however, causality is complex and bidirectional.
Genetic/causal insights: Recent Mendelian-randomization work suggests the relationship between circulating cortisol and anxiety/depression is not simply “higher causes disorder” across populations, underscoring that pattern and context (CAR, diurnal slope, reactivity) may matter more than a single static level.
Aim for most days: walking, easy cycling, light strength circuits. This anchors sleep and diurnal slope while building capacity.
Include 1–3 HIIT or heavy strength sessions per week for trained adults. Expect an acute spike; plan them earlier in the day if evening intensity disrupts sleep.
Prioritize 7–9 hours of sleep, nutrition, and de-stressing practices (breathing, mindfulness). These behaviors show measurable improvements in cortisol metrics, especially the CAR.
Persistent fatigue, worsening sleep, plateauing performance, new mood symptoms, or evening “tired-and-wired” patterns warrant reviewing intensity/frequency and, when indicated, medical evaluation.
No. HIIT transiently raises cortisol, then levels fall—often below baseline within hours—with normalization by 24 hours. In trained individuals, such sessions can reduce later stress reactivity.
Not in typical programs. Meta-analyses find no chronic elevation in resting cortisol from endurance or resistance training.
Patterns and regulation (CAR size, diurnal slope, appropriate reactivity and recovery) carry more prognostic weight than a single reading.
At Integrative Psych NYC, exercise prescriptions are folded into comprehensive treatment plans for anxiety, depression, ADHD, and stress-related concerns. We pair graded activity with CBT-based stress skills and sleep hygiene, and we coordinate with your medical team when endocrine evaluation is warranted.
Clinical note: If you have signs of endocrine disease (e.g., rapid weight change, uncontrolled hypertension, purple striae, proximal muscle weakness), or prolonged insomnia/mood change after initiating high-intensity training, seek medical assessment before progressing your program.
Dote-Montero M, et al. Acute effect of HIIT on testosterone and cortisol. Scand J Med Sci Sports. 2021.
Caplin A, et al. Exercise intensity and HPA reactivity to psychosocial stress. Psychoneuroendocrinology. 2021.
Hill EE, et al. Intensity threshold for cortisol elevation during endurance exercise. J Endocrinol Invest. 2008.
Bermejo JL, et al. Acute resistance exercise elevates cortisol. Biol Sport. 2022.
Jansson D, et al. Endurance vs resistance training and basal hormones (meta-analysis). Sports Med Open. 2022.
De Nys L, et al. Exercise interventions, cortisol, and sleep (systematic review/meta-analysis). Prog Neuro-Psychopharmacol Biol Psychiatry. 2022.
Adam EK, Kumari M, et al. Diurnal cortisol slopes and health. 2017.
Lupien SJ, et al. Effects of stress across the lifespan on brain, behavior, cognition. Nat Rev Neurosci. 2009.
Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain. Pain Res Treat. 2014.
Chan II, et al. Mendelian randomization of cortisol with anxiety/depression. Transl Psychiatry. 2024.
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